If you tell someone you have a headache, they might offer you a pain reliever, a glass of water or some quiet time.

Tell someone you have a heartache, and they want to know why.

You can’t say, “I don’t feel like going to the county fair today; I have a heartache.” You can’t bow out of social engagements, leave work early, get a cool cloth and a dark room, or any of the other benevolence that’s bestowed on the sufferer of a headache.

If you say you have a headache, people will nod and leave you alone. Maybe offer you a decongestant if it’s allergy season.

But the heart. If you say your heart is hurting, people want to know why. They want to unearth every permutation of sadness that resides within you, pull it out like a mutated earthworm and examine it as it wriggles and writhes under the light of day. People want you to vomit out your inner turmoil so they can poke a stick in it and see what it tells them about you, like a demented shaman poking a gnarled finger into the guts of an eviscerated chicken.

There are times when your heart just aches, and there’s not a thing anyone can do about it. You just have to ride it out. The trigger isn’t a specific incident, you’re just fucking sad. Like a cold, you have to let the sadness run its course, because there’s no inoculation against it, no old-timey home remedies for it.

Believe it or not, there are some people who don’t want your sympathy, because they don’t have any idea what to do with it. Explaining the cause of their grief is a task so enormous and complex–full of short turns, sharp stops, complete reversals and apparent contradictions–that they don’t have a starting place to make it easily digestible for the people outside of their head.

Other people don’t want your sympathy because it smells and feels and sounds and tastes like condescension. They’d rather cut off their hand than be viewed as someone in need.

Or maybe they just don’t want to hear your armchair diagnosis of depression. As if being sad isn’t acceptable, isn’t serious enough to meet your standards, and their lack of response must have a clinical and treatable cause.

If I were there and part of your everyday circle, I hope I would try to leave you alone for a while and not require songs and explanations. But it’s hard to be sure that I would. We are selfish. But I hope that I would.